Observational studyEpilepsia2015
Practice variability and efficacy of clonazepam, lorazepam, and midazolam in status epilepticus: A multicenter comparison.
Observational study in Epilepsia, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 99 citations in OpenAlex.
- Patterns of benzodiazepine underdosing in the Established Status Epilepticus Treatment Trial.Epilepsia · 2021Trial
- Assessment of therapeutic management practices in generalized and focal motor status epilepticus: An international survey in French, Belgian, and Swiss intensive care units.Journal of intensive medicine · 2026Article
- Prehospital rescue treatment of cluster epileptic seizures and status epilepticus.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Review
- Underdosing and response to pharmacotherapy in patients with status epilepticus: a retrospective study from Saudi Arabia.Annals of medicine · 2025Article
- Diagnosis, treatment, and outcome prediction of non-convulsive status epilepticus in unconscious patients in intensive care units.Neurological research and practice · 2025Review
- Guidelines adherence in status epilepticus first steps treatment: factors associated with non-compliance and effect on outcome.Journal of neurology · 2025Article
- Time to treatment in pediatric patients with repeated episodes of status epilepticus.BMC neurology · 2025Observational
- Assessment of benzodiazepine dosing in status epilepticus patients in the emergency department.Frontiers in neurology · 2025Article
- Status epilepticus in the ICU.Intensive care medicine · 2024Review
- Further advances in epilepsy.Journal of neurology · 2023Review
- Article
- Management of convulsive status epilepticus: recent updates.Encephalitis (Seoul, Korea) · 2023Review
- Review
- Optimal Management of Status Epilepticus in Children in the Emergency Setting: A Review of Recent Advances.Open access emergency medicine : OAEM · 2022Review
- [S2k guidelines: status epilepticus in adulthood : Guidelines of the German Society for Neurology].Der Nervenarzt · 2021Review
- Treatments for Convulsive and Nonconvulsive Status Epilepticus in Adults: An Expert Opinion Survey in South Korea.Journal of clinical neurology (Seoul, Korea) · 2021Article
- Article
- Underdosing of Benzodiazepines in Patients With Status Epilepticus Enrolled in Established Status Epilepticus Treatment Trial.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2019Article
- Nonconvulsive seizures and nonconvulsive status epilepticus in the neuro ICU should or should not be treated aggressively: A debate.Clinical neurophysiology practice · 2019Review
- Treatment of Refractory and Super-refractory Status Epilepticus.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
Abstract
objectiveBenzodiazepines (BZD) are recommended as first-line treatment for status epilepticus (SE), with lorazepam (LZP) and midazolam (MDZ) being the most widely used drugs and part of current treatment guidelines. Clonazepam (CLZ) is also utilized in many countries; however, there is no systematic comparison of these agents for treatment of SE to date.
methodsWe identified all patients treated with CLZ, LZP, or MDZ as a first-line agent from a prospectively collected observational cohort of adult patients treated for SE in four tertiary care centers. Relative efficacies of CLZ, LZP, and MDZ were compared by assessing the risk of developing refractory SE and the number of antiseizure drugs (ASDs) required to control SE.
resultsAmong 177 patients, 72 patients (40.62%) received CLZ, 82 patients (46.33%) LZP, and 23 (12.99%) MDZ; groups were similar in demographics and SE characteristics. Loading dose was considered insufficient in the majority of cases for LZP, with a similar rate (84%, 95%, and 87.5%) in the centers involved, and CLZ was used as recommended in 52% of patients. After adjustment for relevant variables, LZP was associated with an increased risk of refractoriness as compared to CLZ (odds ratio [OR] 6.4, 95% confidence interval [CI] 2.66-15.5) and with an increased number of ASDs needed for SE control (OR 4.35, 95% CI 1.8-10.49). SIGNIFICANCE: CLZ seems to be an effective alternative to LZP and MDZ. LZP is frequently underdosed in this setting. These findings are highly relevant, since they may impact daily practice.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.